Homestead_OpiparyCLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
t State Fpm 5473 (R6 / d-03)
PrasaiEed by Na Department of Local Gwemment Finance
INSTRUCTIONS: See reverse side for filing instn/ctions.
FORM �� YEAR _
HC10 � I I
u
i�ve) ( npQ r n�7
� - certify that on the4s�bf March, 20
I(We) occupied as our principal place o( residence th follo ing described real property for which a Homestead Property T�c Credit is hereby daimed:
❑ I(We) owned � Are buying under contracl �'fa�, �Q�,
, Have a benefidal interest in the enGty that is liable for the property taxes on the property and that ownsthe pmperty�w,is�buyi gunder a wntract.
V�..._ _
If buying
remrded
CounTy
Parcel number
�-i,� - o7-a o y -o�
tl any portion of Na residemial sW cture w
ol the propem� utiGZed tn produce income.
Tovnship
Legal description
Is Ule
Record number � Page
❑ Mobile Homo (I.C. G7.
not exceeding one (1) ave that immediatety sunounds Nat swGUre is used tn produce income, tlesuibe Ihe use and ponion
�ooa a-71�
3 r��s��-'�.�A�SSES OR� SEONLY r� h�'"i1TRUETAX� ASSESSEDVALUE � HOMESTEAD~"� �T N N-RESfOENTIAL
���Seu.'�>/��:#+�.�y.i� �M..�i����VAUIE$t�� AT.100%�0.�."TN�'eE�iVALUE.�i:��Y.� �VALUE 1�
�""' .�. �-�:*Ss, x�. �-�i
Land not exceeding 1(one) acre immediately �'s� -� ',�r�-v r.%,�.����,�
surrounding residenlial improvements. (�� ���-�"��"�������''�'
':�.3`�=�tiz,v._.a, sr_, � _.: ' .
Other land � Z �����. . •��' v'f
( 1 is'r�'�zi3�� ��!�
R."-3:.YtII.v: �"i �
Tcfal land (line 7 plus line 2) �3�
� ''� �y h*�����`r��� _�ry
Dwelling (4) + ���� �.�
Residential improvements wMnuaOy ==��� �v� '�
Assessed Mobiie / Manufacturad Home Garage 5 �"�� � G
( ) �zu,.:. `--= .y {, : s;te�"-�F�
5,.��:s�.n;�'�;;�.=.' " '� � .. �i�+
Otherimprovements �g� kg i�'����
�� i �
Total improvements (line 4 through line 6) (��
Tdal value (line 3 plus line n (g�
I hereby certify Ihe above is We, corred, and Signature otnssessor Date signed
complete.
Verifying action - Signature oflwditor Date siqned
�'F'�^��.�ti'�Y.t-7--,�:�`ai���'.��s�+��`i3'��STANDARU:DE�UCTIONALLOWANCE*�t':,'r.E�`s,.�'5:.���',r�r3C�"" i- "e . "
,�:e"�"���a:.
20�Pay20� �
Lesser o� 1i2 Homestead
vauauon w E35.000 S �
Signature of Auditor � Date signed